Interview with Svea Welch: The Challenges of Outpatient Addiction Treatment


Many patients in treatment for drug dependence opt for outpatient care. Compared to residential drug rehabs, outpatient addiction treatment programs offer more flexibility and are usually less expensive – a combination that often makes the idea of treatment more palatable to those who are often uncertain about their commitment or their ability to leave work or home.

However, outpatient addiction treatment is still a challenging experience. In addition to a rigorous daily schedule of therapeutic interventions and treatments, patients are tasked with avoiding relapse during the critical first weeks of early recovery while attempting to manage the stressors of day-to-day life and relationships.


For some, it’s the only option. For others, it’s the best option. Is it the right option for your family member?


Unique Experience, Unique Treatment


personal obstacles

Mrs. Svea Welch has a master’s degree in clinical psychology with a counseling specialization and a concentration in treatment of addictions from the Chicago School of Psychology in Chicago, Ill. She has specialized in addiction treatment throughout her career and has been a therapist at The Oaks at La Paloma treatment center in Memphis, Tenn., for a year.

Mrs. Welch sees outpatient therapy as a unique journey for each patient. She says: “Some can find success in outpatient treatment, while others benefit from higher levels of care, such as residential treatment. It is important for therapists to meet the client where they are in order to motivate them toward change and the appropriate programing.”

Because each patient has a unique perspective due to experience prior to and during addiction, his or her experience in rehab should be unique as well. Outpatient therapy can explore the individual needs of each patient – the obstacles they face on a personal level – and provide the opportunity to access diverse therapeutic options out in the community as well.

Patient-Directed Treatment

In order to meet patients where they are in terms of their readiness to stop drinking and using drugs and turn their lives in a new direction, Mrs. Welch utilizes a couple of different approaches: “I use Motivational Interviewing skills and Dialectical Behavioral Therapy (DBT). Both are important in meeting the client where they are and moving them toward their desired goals, while providing them with skills to regulate emotions, become effective in relationships, and manage stressful situations.”

By utilizing therapy styles like Motivational Interviewing and Dialectical Behavioral Therapy, both proven to be effective in the treatment of addiction in patients who may be in varying stages of readiness for recovery, patients can move at their own pace and work on the big issues that may be creating a barrier to their ability to remain sober – or even to imagine a life without drugs and alcohol.

motivational interviewing

Environmental Obstacles


When active in addiction, most patients live in dysfunctional relationships, spend their time non-productively or even harmfully, and use drugs and/or alcohol as a their sole means of managing stress. When they choose outpatient treatment, the only change they make initially is stopping use of their drug of choice. The continued interaction with all the stressors and situations that may have originally promoted their drug and alcohol use can make it hard to remain sober.

Says Mrs. Welch: “It can become difficult when the client discovers that they may have to change the people,

places and things that are similar to achieve their desired goals. Therapy is helpful in assisting the client in identifying red flags and triggers and developing a solid relapse prevention plan.”

Because the patient returns home after treatment each night, he has the opportunity to immediately begin to put into practice his new coping mechanisms learned in therapy – and if he has any questions or has a problem, he can bring it back to treatment the following day and get the guidance he needs to continue moving forward.

Family Support

Because the patient does not have the benefit of positive, recovery-focused support around the clock as he would if he enrolled in residential treatment, the people at home can play a large part in his ability to maintain sobriety. If they understand addiction and how it affects the patient both during and after use as well as how treatment works and how they can best be a proactive part of their loved one’s recovery, then the patient’s ability to remain clean and sober is improved.

To that end, there are a number of opportunities available to family members through their addicted loved one’s outpatient treatment program. Says Mrs. Welch: “Outpatient treatment also provides weekly family educational groups to provide support to the family, while assisting family members in the development of boundaries, effective communication and understanding enabling behaviors.”

Family therapy can be helpful as well, providing the patient and his family members with a safe forum. In this space, they can discuss potentially explosive issues with the guidance of a therapist who can help them to utilize positive communication skills that will benefit them for a lifetime.

family therapy

Get the Most Out of Treatment

avoid relapse

Mrs. Welch affirms that patients can get out of outpatient treatment everything that they put into it. Lasting recovery takes more than just showing up to therapy sessions – though getting in the door is the first step. Rather, Mrs. Welch encourages patients to:

  • Take advantage of opportunities out in the real world to apply the coping mechanisms learned in therapy
  • Create a solid community support system
  • Focus on finding the balance between managing daily responsibilities and growth in recovery through treatment
  • Avoid risky situations – including people, places, and things – that could trigger relapse
  • Utilize community support services

Additionally, Mrs. Welch says that doing the work while in treatment is an important part of success as well. She recommends that patients show up to sessions on time, take an active role in groups, do recommended homework, and, in general, stay active in their own recovery and treatment, taking advantage of all positive opportunities that come their way and avoiding anything that puts their recovery at risk.

Co-occurring Issues

For most patients, drug and alcohol use is only part of the problem and, in some cases, a symptom of an underlying issue. For them, recovery is more than just learning how to utilize more positive coping mechanisms in stressful situations; it’s about getting intensive treatment for all underlying or co-occurring disorders in order to be stronger in recovery.

Mrs. Welch believes that a major part of the work done in outpatient treatment is identifying “antecedents that lead to substance abuse.” For some patients, this can mean that they drink or use drugs as a way to manage the symptoms they experience due to a mental health disorder like depression or anxiety, or to aid them in dealing with a troubling and dysfunctional relationship or ongoing environmental stressor. True change that is long-lasting will only be attainable for these patients if they address these underlying issues, making definitive changes when necessary, in order to learn how to better manage the underlying issue and/or mitigate its effects entirely.


Is Outpatient Rehab the Right Choice for Your Addicted Loved One?

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that more than 23 million Americans over the age of 12 are in need of treatment for an alcohol or drug use disorder. 

That’s more than nine percent of the population over age 12. If your loved one is among this number, he or she is not alone. However, your loved one’s experience will be different from everyone else’s and will require a personalized treatment plan as a result, whether in residential care or outpatient treatment.

If you would like to learn more about the options available to your addicted loved one through residential or outpatient care, contact us at The Oaks at La Paloma today. We can answer your questions and help your loved one and your family move a step closer to the recovery that will help your family begin the healing process. Call now to begin.